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CARDIOVASCULAR ANESTHESIA

The Pharmacokinetics of Hemoglobin-Based Oxygen Carrier Hemoglobin Glutamer-200 Bovine in the Horse

Lawrence R. Soma, VMD^*, Cornelius E. Uboh, PhD^*, Fuyu Guan, PhD^*, Yi Luo, PhD^*, Peter J. Moate, Magr, SC^*, Raymond C. Boston, PhD^*, and Bernd Driessen, DVM, PhD^*

*Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania; Department of Chemistry, Pennsylvania Equine Toxicology & Research Center, West Chester University; and Department of Anesthesiology, David Geffen School of Medicine, University of California-Los Angeles

Address correspondence and reprint requests to Lawrence R. Soma, VMD, University of Pennsylvania, School of Veterinary Medicine, New Bolton Center Campus, 382 West Street Rd., Kennett Square, PA 19348. Address e-mail to soma{at}mail.vet.upenn.edu.

Hemoglobin-glutamer-200 (HBOC-200) is a hemoglobin (Hb)-based oxygen carrier (HBOC) comprising glutaraldehyde-polymerized bovine Hb. In this study, we sought to determine the pharmacokinetics of this first generation HBOC after IV infusion of 32.5 g of HBOC-200 solution in horses. Quantification of HBOC-200 in equine plasma and urine was performed using a method recently developed by our laboratory. The elimination from plasma was based on size distribution of the bovine Hb polymer. The decline of plasma concentration-time curve of HBOC-200 was described by a noninterchanging 2-compartmental model. The median elimination half-lives of the small and large aggregates were 1.3 and 12.0 h, respectively. Of the HBOC-200 infused, 47.0% was eliminated as the smaller molecular weight and 53% as the larger molecular weight polymers. The area under the plasma concentration-time curve was 5143.1 µg · h^–1 · mL^–1. The volumes of distribution of the small and large aggregates were 86.9 and 63.9 mL/kg and the clearances were 42.1 and 3.8 mL · kg^–1 · h^–1, respectively. In conclusion, elimination of first generation HBOCs was shown to be more complex than previously assumed because of the heterogeneous nature of these solutions. Mammalian species dispose of Hb using similar mechanisms, and there is no unique metabolic process in the horse that would not allow a logical extension of the general interpretation of this study.

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